Provider Demographics
NPI:1568469435
Name:SCHWENZFEIER, CARL WILLY (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:WILLY
Last Name:SCHWENZFEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7184
Mailing Address - Country:US
Mailing Address - Phone:843-763-0543
Mailing Address - Fax:
Practice Address - Street 1:497 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7184
Practice Address - Country:US
Practice Address - Phone:843-763-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC08647207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC086472Medicaid
SC086472Medicaid
SCB923815449Medicare PIN